Provider Demographics
NPI:1851326128
Name:BHIMANI, JAI P (MD)
Entity Type:Individual
Prefix:MR
First Name:JAI
Middle Name:P
Last Name:BHIMANI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:234 EAST GRAY STREET
Mailing Address - Street 2:SUITE 858
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202
Mailing Address - Country:US
Mailing Address - Phone:502-583-1799
Mailing Address - Fax:502-583-1792
Practice Address - Street 1:234 EAST GRAY STREET
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202
Practice Address - Country:US
Practice Address - Phone:502-583-1799
Practice Address - Fax:502-583-1792
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA043330207R00000X
KY40711207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000752969CMedicaid
GA582497420OtherTAX ID
GA000752969CMedicaid
GA11BDRBMMedicare ID - Type Unspecified